The 2023 Florida Statutes (including Special Session C)
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. . . By letter dated January 28, 2016, and mailed to Rogers, Chase demanded that Rogers pay $413.40. . . .
. . . . § 413.40. . . .
. . . See 42 C.F.R. § 413.40(c)(4)®-(ii) (2003). . . . Id. § 413.40(c)(4)(iii). . . . Id. § 413.40(c)(4)(iii)(A)(I). . . . Id. § 413.40(c)(4)(iii)(B). . . . Nothing in § 413.40 compels this Court to adopt Fayetteville’s reading. . . .
. . . See 42 C.F.R. § 413.40(c)(4)(i)-(ii) (2003). . . . Id. § 413.40(c)(4)(iii). . . . Id. § 413.40(c)(4)(iii)(A)(I). . . . Nothing in § 413.40 compels this Court to adopt Fayetteville’s reading. . . . Reg. 49,982, 50,103-04 (Aug. 1, 2002) (“In accordance with existing §§ 413.40(c)(4)(h) ... . . .
. . . . § 413.40(c)(4). So far, so good. . . . Id. § 413.40(c)(4)(iii)(A). . . . Id. § 413.40(e)(4)(iii)(B). . . . Id. § 413.40(e)(4)(iii). . . . See id. at 16; 42 C.F.R. § 413.40(c)(4)(iii). . . .
. . . . § 413.40(a)(3). . . . .
. . . . § 413.40. . . . See 42 C.F.R. § 413.40(c)(4)(i)-(ii). . . . See 42 C.F.R. § 413.40(c)(4)(iii). . . . . § 413.40(c)(4)(iii)(A). . . . . § 413.40(c)(4)(iii)(B). . . .
. . . . § 413.40(g)(1)(H). B The University of Texas operates a cancer hospital, the M.D. . . .
. . . . § 413.40(c)(4)(iii). . . . interplay between subsections (b)(3)(A) & (b)(3)(H) of 42 U.S.C. § 1395ww, CMS’s regulations at 42 C.F.R. § 413.40 . . . reasonable to explicitly incorporate the BBA cap into the meaning of “target amount” through 42 C.F.R. § 413.40 . . .
. . . . § 413.40(g)(l)(iii), the PRRB concluded that the Secretary was prohibited from making the adjustment . . . rate-of-increase ceiling” before the Secretary will make a § 1395ww(b)(4)(A) adjustment. 42 C.F.R. § 413.40 . . . operating costs beyond the TEFRA ceiling” and not an “increase in potential operating costs.” 42 C.F.R. § 413.40 . . . correctly determined that Beacon was not eligible for a TEFRA target cost adjustment under 42 C.F.R. § 413.40 . . . on the merits, holding Beacon was not entitled to a TEFRA target cost adjustment under 42 C.F.R. § 413.40 . . .
. . . . § 413.40(a)(3). Reimbursements could not exceed the ceiling. . . . See 42 C.F.R. § 413.40(c)(4)(i)-(ii). . . . See 42 C.F.R. § 413.40(c)(4)(iii). . . . . § 413.40(c)(4)(iii)(A). . . . . § 413.40(c)(4)(iii)(B). . . .
. . . Put another way, without actuarial gains and losses that were being amortized in accordance with CAS 413.40 . . .
. . . . § 413.40. . . . See generally 42 C.F.R. § 413.40. . . . hospital services, that would result in a “significant distortion in the operating costs.” 42 C.F.R. § 413.40 . . . be granted for certain factors, including “a change in the inpatient hospital services.” 42 C.F.R. § 413.40 . . . The Clerk of Court CLOSE this case. . 42 C.F.R. § 413.40(g)(3) provides, in relevant part: (i) Adjustment . . .
. . . . § 413.40(b)(l)(i) (hereafter “subsection (i)”), states that once a TEFRA target amount is established . . . The second provision, 42 C.F.R. § 413.40(b)(1)(h) (hereafter “subsection (ii)”), states that the base . . . See 42 C.F.R. § 413.40(f). . . . Section 413.40(f) defines a "new hospital” as "a provider of hospital inpatient services that (A) [h] . . . Id. § 413.40(f)(l)(ii). . . .
. . . those transferred as part of a segment closing transaction, in computing pension costs pursuant to CAS 413.40 . . .
. . . . § 413.40. . . . See 42 C.F.R. § 413.40(e)(1). . . . Pri- or to October 1, 1995, and thus during Saint Marys’s 1994 cost reporting period, § 413.40(e)(1) . . . To “clarify” the ambiguity, CMS proposed an amendment to § 413.40(e)(1) in June 1995. See 60 Fed. . . . In sum, regardless of the 42 C.F.R. § 413.40(e)(1) version applied, Saint Mar-ys’s appeal fails. . . .
. . . . §'413.40(b)(1) & (c)(3). . . . (F) The manipulation of discharges to increase reimbursement. 42 C.F.R. § 413.40(g). 6.In addition, CMS . . . See, e.g., 42 U.S.C. § 1395oo; 42 C.F.R. § 413.40(e)(4). . . . A section of the relevant regulation, 42 C.F.R. § 413.40(g)(3), specifically mentioned FICA taxes as . . . the “significant distortion” nor “extraordinary circumstances” adjustments outlined in 42 C.F.R. § 413.40 . . .
. . . . § 413.40(a); pension costs must be allocated to segments of an organization, see § 413.40(c); actuarial . . .
. . . 185-15399-14117 3,963.66 FGC: Vanguard 0050/09877867914 14,073.62 FGC: Terra Nova Trading 32012928 413.40 . . .
. . . . § 413.40(c) (2002). . . .
. . . . § 413.40(a)(3)(D). Medicare, however, does not cover the full per diem rate. . . .
. . . Because CAS 413.40(a) requires a contractor to make an actuarial valuation annually, the amortization . . . Id. § 413.40(a). . . .
. . . . § 413.40(b)(1) (1993); Tucson Medical Center [v. . . . the base year by a legislatively determined percentage. 42 U.S.C. § 1395ww(b)(3) (1988); 42 C.F.R. § 413.40 . . . half the difference between its costs and the ceiling. 42 U.S.C. § 1395ww(b)(l)(A) (1988); 42 C.F.R. § 413.40 . . . regulation defining the TEFRA base year, 42 C.F.R. § 405.463(b)(1) (1982) ( renumbered as 42 C.F.R. § 413.40 . . . first period of at least 12 months subsequent to that short period is the base period. 42 C.F.R. § 413.40 . . .
. . . . § 413.40(b)(1) (1993); Tucson Medical Center [v. . . . the base year by a legislatively determined percentage. 42 U.S.C. § 1395ww(b)(3) (1988); 42 C.F.R. § 413.40 . . . half the difference between its costs and the ceiling. 42 U.S.C. § 1395ww(b)(l)(A) (1988); 42 C.F.R. § 413.40 . . . regulation defining the TEFRA base year, 42 C.F.R. § 405.463(b)(1) (1982) (renumbered as 42 C.F.R. § 413.40 . . . first period of at least 12 months subsequent to that short period is the base period. 42 C.F.R. § 413.40 . . .
. . . . § 413.40 in 1982 and subsequently amended relevant portions of those regulations. . . . HCFA granted it approval to participate in the Medicare program, for less than 2 years. 42 C.F.R. § 413.40 . . . See 42 C.F.R. § 413.40 (2001). B. Factual Background Plaintiff P.I.A. . . . , or at least a change in its TEFRA limit base year from 1984 to 1989-90 under § 413.40(b). . . . (h)(1989) (codified as revised at 42 C.F.R. § 413.40(g)(2001)), provided a mechanism for adjustment to . . .
. . . . § 413.40(g). . . .
. . . actuarial gains and losses shall be calculated annually and assigned to specific cost accounting periods, § 413.40 . . . (a), and that pension costs shall be allocated to segments of an organization, § 413.40(e). . . . Id. § 413.40. . . .
. . . . § 413.40(e). . . . . § 413.40(e)(2), (3). . . .
. . . . § 413.40, which they contend interprets subsection (b)(3)(A) in a manner contrary to 42 C.F.R. § 412.71 . . . In particular, they argue that 42 C.F.R. § 413.40 interprets the language, “the first such reporting . . . (b)(3)(A) should not be accorded deference because 42 C.F.R. § 413.40(b) and two comments made by the . . . Assuming that 42 C.F.R. § 413.40(b) and the Secretary’s 1986 comments evidence an interpretation of ( . . .
. . . . § 413.40 Under TEFRA, a target amount is set for each provider based on its allowable inpatient costs . . . for a base-period. 42 C.F.R. § 413.40(c)(4). . . . by applying a rate-of-increase or update factor to the target amount of the base period. 42 C.F.R. § 413.40 . . . if the operating costs are less than the target amount, the provider receives a bonus. 42 C.F.R. § 413.40 . . . See 42 C.F.R. § 413.40(c)(4). . . .
. . . . § 413.40. (Dkt. 1, Paragraph 12). 8. . . . . § 413.40(b)(1). Using these costs, the Secretary computes a “target amount” for each hospital. . . . See generally 42 C.F.R. § 413.40. (Dkt. 1, Paragraph 14). 11. . . . Second, HCFA relied on 42 C.F.R. § 413.40(g)(1), which provides that a TEFRA adjustment may only be granted . . . the base period against which such increase is measured).” 42 U.S.C. § 1395ww(b)(4)(A); 42 C.F.R. § 413.40 . . .
. . . Loan $ 583.94 $ 246.30 Net $1,265.20 $1,069.25 Monthly equivalent Other Income: 200.00 Tax Refund _ 413.40 . . . child support should be increased from the current figure of Four Hundred Thirteen and 40/100 Dollars ($413.40 . . .
. . . . § 413.40(e) was untimely. . . . Discussion The Hospital argues that the plain language of 42 C.F.R. § 413.40(e), as it existed at the . . . The Secretary’s interpretation is not inconsistent with the language of 42 C.F.R. § 413.40(e). . . . Rather, exception requests to TEFRA target rate limits are governed by 42 C.F.R. § 413.40(e). . . . However, these regulations provide guidance for interpreting § 413.40(e). . . .
. . . Income— John Melton Debra Melton (bi-weekly) (weekly) $1,430.71 $365.38 Gross 85.72 433.37 413.40 Less . . . 246.75 Net Monthly equivalent 1.265.20 1,069.25 Other income: Tax refund 200.00 Child support/alimony 413.40 . . .
. . . . § 413.40(b)(1), (c)(2). . . . cost fall below the target amount, the provider receives some portion of this difference. 42 C.F.R. § 413.40 . . . Id. at § 1395ww(b)(4); 42 C.F.R. § 413.40(e). . . . . § 413.40(e)(1). . . . Id. at § 413.40(e)(2)-(5). . . .
. . . . § 413.40(f)(1) (1986), formerly 42 C.F.R. § 405.463(f)(1) (1984). . . . The PRRB majority reasoned that the plain language of 42 C.F.R. § 413.40(f)(1) focused solely on the . . . Emphasizing the purpose of the new hospital exemption, and the term “has operated” in § 413.40(f)(1), . . . The Secretary’s interpretation of 42 C.F.R. § 413.40(f)(1) is both linguistically possible and consistent . . . In these circumstances, we must defer to the Secretary’s interpretation of 42 C.F.R. § 413.40(f)(1). . . .
. . . Section 405.463 was subsequently renumbered and now appears without substantive change as section 413.40 . . .
. . . . § 413.40(b)(1) (1993); Tucson Medical Center, 947 F.2d at 975. . . . For example, under 42 C.F.R. § 413.40(g)(3)(ii)(D) (1993), an “[i]ncrease[ ] in service intensity or . . . Section 413.40(i) of the regulation, which applies to years beginning after 1990, permits the Secretary . . . It instead must send the request to HCFA for review. 42 C.F.R. § 413.40(e) (1993). . . . It may apply for an adjustment under Section 1395ww(b)(4)(A) and 42 C.F.R. §§ 413.40(g), 413.40(i) (1993 . . .
. . . . § 413.40(f)-(g). . . .
. . . . § 413.40(g)(2) (1990)) or if the hospital had experienced a change in its “case mix” (42 C.F.R. § 413.40 . . . In addition, 42 C.F.R. § 413.40(h), which bore the heading “Adjustments,” provided in pertinent part: . . . In 1991, these provisions were combined to form what is now 42 C.F.R. § 413.40(g) (1993). . . . See 42 U.S.C. §§ 1395ww(b)(4)(A)-(B) (Supp.1993); 42 C.F.R. § 413.40(i). . . . . § 413.40(g). . . .
. . . . § 413.40(b)(1) (emphasis added). . . . This preceding 12-month period is called in the regulation the “base year;” id. at § 413.40(b)(1), despite . . . (g)(1), as well as guidelines for seeking assignment of a new base period, id. at § 413.40(h)(4)(i). . . . While the regulation states at 42 C.F.R. § 413.40(g)(1), “[the Health Care Finance Administration] may . . . Sullivan, 947 F.2d 971, 974 (D.C.Cir.1991). . 42 C.F.R. § 413.40. . . . .
. . . . § 413.40 (1992). TEFRA also set out specific exceptions and adjustments to the new limits. . . . Id.; see also 42' C.F.R. § 413.40(f)-(g) (exemptions and adjustments). . . .
. . . . § 405.463 (redesignated as § 413.40). . . . § 413.130 [formerly § 405.-414], return on equity capital as described in § 413.157.... 42 C.F.R, § 413.40 . . .
. . . . § 413.40(e) (emphasis added). . . . . § 413.40(h)(l)(i) (emphasis added). . . . . § 413.40(h), an adjustment to the base year costs that establish its cost per case and TEFRA increase . . . . § 413.40(h) (1988). . . . The Medical Center then filed a request for a base year adjustment, pursuant to 42 C.F.R. § 413.40(h) . . . exception” to its 1986 TEFRA target amount, pursuant to 42 U.S.C. § 1395ww(b)(4)(A) and 42 C.F.R. § 413.40 . . .
. . . . §§ 413.40(g)(2) and (h). . . .
. . . Section 413.40 of CAS provides that a contractor is required to calculate actual gains and losses on . . .
. . . See, e.g., Headnotes to items 412.76 through 413.40, TSUS ("Aromatic or odoriferous compounds * * *”) . . .
. . . See, e.g., Headnotes to items 412.76 through 413.40, TSUS (“Aromatic or odoriferous compounds ... ”). . . .
. . . . § 413.40(a)(1) (implementing regulations). . . . . § 413.40(d). The incentive payments are known as “TEFRA bonuses.” . . . The TEFRA regulations, 42 C.F.R. § 413.40, state that TEFRA bonuses and penalties should be “determined . . . They refer to both TEFRA bonuses and TEFRA penalties as “reimbursement.” 42 C.F.R. § 413.40(d)(1), (iii . . . Id. § 413.40(d)(l)(i), (iii), (iv). . . .
. . . allowable in-patient operating costs incurred in the year immediately preceding the payment. 42 C.R.F. 413.40 . . .
. . . .-01(a) and 413.40 (1986). (Complaint at ¶ 16). . . .
. . . For the period from July 1 to August 5, 1980, he earned gross wages of $413.40. . . .
. . . month- $9,333.41 5-1-52 through 3-31-55 at $363.10 per month- 12, 708.50 4r-l-55 through 5-31-58 at $413.40 . . .